CA 19-9

Definition

Measures a protein in the blood called CA 19-9 (cancer antigen 19-9). It is a tumor marker, a substance produced by cancer cells or by normal cells responding to cancer. It is used mainly for monitoring pancreatic cancer.

Purpose

To monitor the course of the cancer and the effectiveness of treatment (the level rises as the tumor grows and falls as it shrinks); to help determine prognosis and stage; to detect recurrence after treatment.

Results

ChangeInterpretation
RisingThe tumor may be growing; treatment may not be working
FallingThe tumor may be shrinking; treatment appears to be working
StableThe disease is unchanged
Rising after treatmentPossible recurrence

Normal Values

Laboratory specific.

Risks and Limitations

This marker has a very important limitation of its own:

Some people do not produce CA 19-9 even when they have a cancer that usually produces high levels.

(These are Lewis antigen negative individuals.) In other words, a normal CA 19-9 does not rule out pancreatic cancer.

Other limitations:

  • Not suitable for screening on its own
  • Non-cancer causes of elevation: gallstones, pancreatitis, liver disease, cystic fibrosis
  • It can also be high in healthy people

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